Drug General Information (ID: DDIHX0SK74)
Drug Name			Zalcitabine		Drug Info		Probenecid		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anti-Hiv Agents				Uricosuric Agents
Structure

Mechanism of Zalcitabine-Probenecid Interaction (Severity Level: Moderate)
Competitive inhibition of renal tubular secretion Click to Show/Hide Mechanism Graph
Drug Name		Zalcitabine				Probenecid
Mechanism		Zalcitabine				Inhibition of the renal tubular secretion of zalcitabine
Key Mechanism Factor 1
		Factor Name		Renal tubular secretion
		Factor Description		Renal tubular secretion allows selective transfer of substances from the blood around the capillaries into the renal tubules via filtrate. Drug excretion may be reduced when two drugs compete for renal tubular secretion.
Mechanism Description		Decreased elimination of Zalcitabine caused by Probenecid mediated competitive inhibition of renal tubular secretion

Recommended Action
Management		Close clinical monitoring for evidence of zalcitabine toxicity (peripheral neuropathy, pancreatitis, lactic acidosis, hepatotoxicity) is recommended when these drugs are used together. In addition, a reduction in zalcitabine dosage may be warranted. Patients should be advised to promptly notify their physician if they experience numbness, tingling, severe nausea and vomiting, diarrhea, abdominal pain, severe fatigue, jaundice, or unusual bleeding or bruising.

References
1	Argov Z, Mastaglia FL "Drug-induced peripheral neuropathies." Br Med J 1 (1979): 663-6. [PMID: 219931]
2	Product Information. Hivid (zalcitabine). Roche Laboratories, Nutley, NJ.
3	Massarella JW, Nazareno LA, Passe S, Min B "The effect of probenecid on the pharmacokinetics of zalcitabine in HIV-positive patients." Pharmaceut Res 13 (1996): 449-52